Disease of the Cerebrum

Question 1

Cerebrum

Answer 1

Consciousness, processing of sensory information (touch, pain, proprioception); skilled responses and motor function
Fascilitates the function of all cranial nerves

Question 2

Thalamus

Answer 2

The relay center for all anatomic divisions of the brain

Question 3

Other subcortical brain structures

Answer 3

Internal capsule, basal ganglia (caudate, putamen, globus pallidus)
Movement, congnition, emotion

Question 4

Clinical Signs of Cerebral Syndrome

Answer 4

Gait abnormalities:
* weakness without ataxia
* Weakness with ataxia and deficits
* Proprioceptive deficits with normal strength

Conformation:
* Circling (“big” circles) and compulsive pacing
* Head turn, body turn

Seizures
Contralateral limb and vision deficits
Behavior changes (obtundation, head pressing, aggression)

Question 5

Canine Distemper Encephalitis

Answer 5

Cerebrum, cerebellum, optic tracts, spinal cord

Question 6

Canine distemper encephalitis:
Clinical signs

Answer 6

Blindness
seizures
central vestibular
Cerebellar
spinal cord
myoclonus

Hyperkeratosis of foot pads, gold-medalion lesions on retina

Question 7

Canine Distemper Encephalitis
Diagnosis:

Answer 7

PCR (urine, conjunctival, pharyngeal, nasal, blood);
CSF - mononuclear pleocytosis and increased CDV IgG

Question 8

Steroid-Responsive Meningitis Arteritis (SRMA)

Answer 8

AKA aseptic meningitis
#2 inflammatory CNS disease (#1 sterile inflammatory disease)

Young (8-18 mo), large breed dogs

Question 9

SRMA
Clinical Signs

Answer 9

Neck pain
fever
Stiffness
Ataxia

Question 10

SRMA
Diagnositics

Answer 10

CBC: Leukocytosis with left shift
CSF: Marked neutrophilic pleocytosis
Postive response to steroids

Question 11

SRMA
Therapy

Answer 11

Immunosuppressive prednisone

Question 12

SRMA
Beagle pain syndrome

Answer 12

Necrotizing polyarteritis
Frequently recurrent

Question 13

Bacterial Meningitis, Encephalitis

Answer 13

Middle aged to older
Peracute, acute or gradual onset
Lethargy, reluctance to walk anorexia
Neck pain, hyperthermia, bradycardia, depression, seizures

Question 14

Bacterial Meningitis, Encephalitis
Diagnosis

Answer 14

Elevated WBC, CSF tap (neutrophilic pleocytosis) + culture

Question 15

Bacterial Meningitis, Encephalitis
Treatment

Answer 15

Antibiotics that cross the BBB (fluoroquinolones, 3rd gen. cephalopsporins, Trimethoprim-sulfa, chloramphenicol, doxycycline, macrolides)
Steroids for the first 24-48 hours may be beneficial at an anti-inflammatory dose

Question 16

Fungal Meningoencephalitis

Answer 16

Cryptococcus, Histoplasmosis, Blastomycosis

Dog and Cat

Signs consistent with bacterial meningitis
Often a component of systemic disease
Funcdic exam: fungal plaques

Question 17

Fungal Meningoencephalitits
Diagnosis

Answer 17

CSF
Urine antigen testing
Serology

Question 18

Fungal Meningoecephalitis
Treatment

Answer 18

Fluconazole, Itraconazole
Amphotericin B
Posaconazole, Voriconazole (cats)

Question 19

Meningeoncephalits of Unknown of Etiology (MUE or MUO)

Answer 19

Toy breeds, females, 1-8 years

Diffuse or coalescing lesions

Question 20

MUO subsets
Granulomatous Meningoencephalitis

Answer 20

Ocular form: acute or subacute vision loss
Focal form: mass lesion
Disseminated form: multifocal signs

Question 21

MUO subsets
Pug Dog Encephalitis (PDE)

Answer 21

Uncommonly seen today
Acute and chronic forms
Seizures, abnormal behavior, gait, posture
Circling, head tilt, head pressing, blindness

Femal pug, Fawn colored <7yrs
Genetic susceptibility testing available

Question 22

MUO / GME / NME / PDE
Diagnosis

Answer 22

Suspicion based on clinical signs, signalment
CT, MRI
CSF: monoculcear to mixed pleocytosis, elevated protein

Question 23

MUO / GME / NME / PDE
Therapy

Answer 23

Prendisone
Cyclosporine
Cytosine arabinoside
Leflunomide, Mycophenolate
Antiepileptics (PDE)